Medicare Whistleblower Attorney
Our Attorneys Assist Whistleblowers with Reporting Medicare Fraud to the Federal Government
Medicare fraud is a pervasive issue in all segments of the healthcare industry. From healthcare providers to pharmaceutical companies and durable medical equipment (DME) manufacturers, all types of entities can—and do—commit Medicare fraud, and this fraud costs U.S. taxpayers tens of billions of dollars annually.
This is why serving as a Medicare fraud whistleblower is so critically important.
Our Medicare fraud whistleblower lawyers help current employees, former employees, and other individuals expose fraud under Medicare and other federal healthcare programs. If you are prepared to report fraud, we are prepared to help you. If you have questions about reporting fraud, we can help you in this scenario as well, and we provide all of our whistleblower services at no out-of-pocket cost to our clients.
Whistleblowers Can Report All Forms of Medicare Fraud to the Federal Government
Our whistleblower team helps individuals expose fraud under all federal health insurance programs. While fraud is a major issue under all of these programs, Medicare fraud is the biggest issue by far. The U.S. Department of Justice (DOJ) routinely pursues Medicare fraud cases—but, it can only do so when it knows that enforcement action is warranted.
Are you eligible to serve as a Medicare fraud whistleblower? We help healthcare whistleblowers expose all forms of fraudulent conduct to the federal government. This includes (but is not limited to):
Billing and Coding Errors
Fraudulent billing is among the most common issues exposed through whistleblower lawsuits involving Medicare. While this includes intentional billing fraud (more on this below), inadvertent billing and coding errors also constitute fraud under the False Claims Act. Healthcare providers routinely commit fraud by making mistakes such as upcoding, unbundling, and billing for services that do not qualify as “medically necessary” under the Medicare program.
Intentional Billing Fraud
Healthcare providers and other entities that intentionally engage in fraudulent billing practices can be held civilly or criminally liable in False Claims Act cases initiated by Medicare whistleblowers. When hospitals, clinics, other healthcare providers, and other entities knowingly obtain taxpayer funds through fraudulent means, they can—and should—be held fully accountable in the federal legal system. If you have information about intentional billing fraud, our lawyers can help you file a whistleblower case under the False Claims Act.
Prescription Drug and DME Fraud
Along with upcoding, billing for unnecessary medical services, and other forms of billing fraud, we also help whistleblowers expose prescription drug and DME fraud. Our experienced healthcare fraud attorneys are intimately familiar with the rules that apply to billing Medicare for prescription drugs and DME—including the rules pertaining to rebates, referral fees, and other forms of remuneration. Exposing prescription drug and DME fraud generally involves filing a qui tam case under the False Claims Act as well.
Anti-Kickback Statute and Stark Law Violations
The Anti-Kickback Statute and Stark Law are federal laws that prohibit healthcare providers and other entities from offering, paying, soliciting, or receiving illegal kickbacks, cash payments, and other forms of remuneration for referring patients covered under Medicare. These are all classified as forms of health care fraud, and they are all covered under the False Claims Act. If you have (or believe you may have) information about a fraud scheme related to referring patients for designated health services, we encourage you to contact us for more information.
Other Fraudulent Practices
We help whistleblowers expose all other types of fraudulent practices involving the Medicare and Medicaid programs as well. If you have questions about exposing any form of fraud within the federally funded healthcare system, our attorneys can help you make informed and confident decisions about your next steps. We have extensive experience working with the government agencies that handle healthcare fraud investigations; and, if you decide to come forward, we can use our experience to work with these agencies effectively on your behalf.
Serving as a Medicare Whistleblower: Filing a Qui TamLawsuit Under the False Claims Act
The False Claims Act is what is known as a “qui tam statute.” This means that it allows private citizens to file lawsuits on the federal government’s behalf. The False Claims Act allows the federal government to pursue both civil penalties and criminal prosecution in the federal courts; and, in all cases, it entitles eligible whistleblowers to a percentage of the funds the government recovers.
How Our Qui TamLaw Firm Can Help
Let’s say you have information about a healthcare provider billing for medically unnecessary services, accepting illegal referral fees, or engaging in another form of Medicare fraud. Why should you contact our law firm? Here are just some of the ways our experienced Medicare whistleblower attorneys can help:
1. Assessing Your Eligibility to Serve as a Medicare Whistleblower
To begin, we can assess your eligibility to serve as a Medicare whistleblower. There are specific eligibility requirements; and, before you come forward, it is critical to ensure that you are eligible to do so. As an experienced whistleblower law firm, we are intimately familiar with the False Claims Act’s eligibility criteria, and we can determine whether you qualify for the protections and financial incentives that are available.
2. Filing Your Whistleblower Complaint Under the False Claims Act
If you are eligible to serve as a Medicare whistleblower and decide to come forward, we can file your whistleblower complaint under the False Claims Act. Here too, strict requirements apply, and it is critical to ensure that you satisfy all of these requirements. If you don’t, you won’t be able to secure the protections (and financial compensation) that are available.
3. Working with the Federal Government on Your Behalf
After filing your whistleblower claim, we will work with the federal government on your behalf. Several of our attorneys handled healthcare fraud cases at the DOJ before entering private practice, so we are well-versed in the DOJ’s procedures for investigating and prosecuting these cases.
4. Advising You and Protecting Your Identity Throughout the Process
Our attorneys will be available to advise you throughout the process of pursuing your whistleblower claim with the federal government. Our attorneys will also work with the government to protect your identity throughout the process. Additionally, while it is unlikely that you will face employer retaliation due the confidentiality protections that are in place, if your employer retaliates against you, we will be prepared to take appropriate legal action on your behalf.
5. Securing Your Whistleblower Reward if Your Case is Successful
If your whistleblower claim leads to the imposition of monetary penalties or the recovery of taxpayer funds, you may be entitled to a whistleblower reward of between 15% and 30% of the government’s recovery. If you become eligible for a reward, our attorneys will work to secure your reward from the U.S. Attorney’s Office, and we will seek a reward percentage that is commensurate with the value of the information and additional assistance you provided.
FAQs: Serving as a Healthcare Fraud Whistleblower
Are there different procedures for reporting Medicare and Medicaid fraud?
The procedures for reporting Medicare and Medicaid fraud are the same. If you have information about both Medicare and Medicaid fraud, our attorneys can assist you with coming forward under the False Claims Act as warranted.
Can I serve as both a Medicare and Medicaid whistleblower?
Yes, it is possible to serve as both a Medicare and Medicaid whistleblower. If, for example, your employer (or former employer) has improperly billed both Medicare and Medicaid, our whistleblower lawyers can assist you with exposing all of the company’s fraudulent billings to the federal government.
When are whistleblower rewards available in healthcare fraud cases?
Whistleblower rewards are available in Medicare and Medicaid whistleblower cases when the information that a whistleblower provides leads to a successful enforcement action. This could be an enforcement action that is civil or criminal in nature.
Can federal employees serve as Medicare fraud whistleblowers?
Federal employees can serve as Medicare fraud whistleblowers. While federal employees generally are not eligible to come forward under the False Claims Act, the Whistleblower Protection Act and Whistleblower Protection Enhancement Act provide similar confidentiality and anti-retaliation protections, and federal employees may be eligible for monetary awards in some cases.
Do I need to hire an attorney to blow the whistle on Medicare fraud?
While not legally required, hiring an attorney to help you blow the whistle on Medicare fraud is strongly recommended. As discussed above, whistleblowers must meet stringent requirements to establish their eligibility for the protections and financial compensation that are available. An experienced whistleblower attorney will be able to assist with doing what it takes to protect your legal rights as you assist the government with uncovering Medicare fraud.
Schedule a Free and Confidential Consultation with a Medicare Whistleblower Attorney Today
If you are interested in speaking with a Medicare whistleblower attorney, we encourage you to contact us promptly. To schedule a free and confidential consultation as soon as possible, call us at 866-320-3959 ortell us how we can reach you online today.